The study evaluates the utility of spleen (SS) and liver stiffness (LS) associated with spleen size (SSZ) as non-invasive markers for predicting high-risk varices (HRV). One hundred thirty-two patients with compensated liver cirrhosis who underwent abdominal ultrasound SS (SSM) and LS measurements (LSM) using a 2-D shear wave elastography (2-D-SWE) technique from General Electric and upper endoscopy were included. Similar rates of reliable SSM and LSM were obtained (95.4% and 97.7% respectively); therefore, 124 patients were included in the final analysis. The optimal cutoff values for SS, LS and SSZ for predicting HRV were 13.2 kPa (area under the receiver operating characteristic curve [AUROC]鈥?鈥?.84), 12.1 kPa (AUROC鈥?鈥?.86) and 12.9 cm (AUROC鈥?鈥?.71), respectively. Including these factors in multiple regression analysis, we obtained the scores for predicting HRV: 0.053鈥痻鈥疭S鈥?鈥?.054鈥痻鈥疞S鈥?鈥?.059鈥痻鈥疭SZ - 1.84. The score\'s optimal cutoff value for predicting HRV was >0.34 (AUROC鈥?鈥?.93). By comparing the AUROC\'s, the score including SSZ, SSM and LSM performed better than each independent factor for predicting HRV (p鈥?鈥?.0091; p鈥?鈥?.0341; p < 0.0001).